Provider Demographics
NPI:1487268793
Name:LIU, MIN YUE ANNA (AGACNP)
Entity type:Individual
Prefix:
First Name:MIN YUE
Middle Name:ANNA
Last Name:LIU
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N BUENA VISTA ST UNIT 105
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3698
Mailing Address - Country:US
Mailing Address - Phone:714-728-2576
Mailing Address - Fax:
Practice Address - Street 1:216 N BUENA VISTA ST UNIT 105
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3698
Practice Address - Country:US
Practice Address - Phone:714-728-2576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014866363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care